Medical Radiology and Radiation Safety. 2021. Vol. 66. № 3. P. 40–47

G.P. Frolov¹, K.N. Melkova², T.I. Gimadova¹, E.I. Klimenko¹

Historical Aspects and Practice of the Use of Total Therapeutic Human Exposure

¹A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia

²ALC Kompas Zdorovya, Moscow, Russia

Contact person: Gennady Pavlovich Frolov: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

The article discusses the historical experience of introducing into practice the clinic of the State Research Center Institute of Biophysics, Ministry of Health of the USSR, the method of irradiation of the whole patient's body on a device containing 137 Cs at a dose of 10–12 Gy before bone marrow transplantation. To ensure the safety of the total therapeutic irradiation method (TTI, total body irradiation – TBI in the world literature), as well as to maintain the specified irradiation parameters, a dose control system was used using thermoluminescent dosimeters (TLD) attached to the patient's body at each irradiation fraction to correct the total dose to the last fraction. In addition to the therapeutic procedure, the TTO model was used to study aspects of verification of emergency exposure and other issues of supporting cases of acute radiation disease. The practical part of the article illustrates the method of radiation dose control using TLD at 22 points when changing the TTI (TBI) technique to a linear accelerator for radiotherapy 6 MeV to perform the procedure with a more preferable dose rate and reduce the patient's exposure time for a fraction of radiation at a dose of 2 Gy for 40 to 20 minutes. The article presents the parameters of the irradiation according to the method and the data obtained on the basis of TLD during the irradiation of the patient according to the modified method. The correspondence of the radiation dose, as well as the irregularity of the irradiation to the specified parameters (less than 10 %), as well as the effectiveness of the use of lung protection with dose reduction from 12 to 8 Gy, is shown. The specified measurements using TLD should be carried out when changing the method at the first actual application, especially in the absence of preliminary phantom measurements. A clear understanding of the principles of radiation therapy in the case of TTI (TBI) is an invaluable experience of doctors, which is used in the treatment of rare cases of acute radiation sickness as a result of emergency (uncontrolled) exposure, both at radiation-hazardous enterprises and with known calculation errors in planning therapeutic radiation.

Key words:radiation therapy, total body irradiation, thermoluminescent dosimeter, bone marrow transplant, equipment for irradiation of the human body, radiation dose control, exposure in a radiation accident.

For citation: Frolov GP, Melkova KN, Gimadova TI, Klimenko EI. Historical Aspects and Practice of the Use of Total Therapeutic Human Exposure. Medical Radiology and Radiation Safety 2021;66(3):40-47.

DOI: 10.12737/1024-6177-2021-66-4-40-47

References

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 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 23.12.2020. 

Accepted for publication: 20.01.2021.